This should be a wake-up call: Shut down the South Bay Inpatient Psychiatric Care Unit

Good Samaritan Hospital will close the inpatient psychiatric facility on its Mission Oaks campus in Los Gatos in August. Santa Clara County has approximately 211 inpatient psychiatric beds, a number that experts say is alarmingly low even without the loss of Mission Oaks 18. (Dai Sugano/Bay Area News Group)

Alexis Crase calls Mission Oaks her safe place.

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The 32-year-old San Jose resident has been admitted to the Los Gatos inpatient psychiatric facility more than 20 times in the past five years for treatment for bipolar disorder, obsessive-compulsive disorder and suicidal thoughts. When she learned that Mission Oaks will close its doors in August, she was shocked.

At this point, I’m much better and was hoping I’d never need to go back there, said Crase, who is active in mental health advocacy and is forthcoming about her own struggles. There’s something about knowing it’s there when I need it, and knowing it won’t be there is a little scary.

Santa Clara County has 211 inpatient psychiatric care beds, a number that experts say is alarmingly low even without the loss of 18 beds in Mission Oaks. A 2018 report from the California Hospital Association recommends at least one public psychiatric bed for every 2,000 residents. Santa Clara County has only 0.26 beds for every 2,000, meaning it needs to nearly quadruple the number of beds by adding about 960 to fully serve the population.

Its closure could not only force patients like Crase to travel out of the county for the critical care they need, but overwhelm emergency departments and push some patients who are diverted to treatment centers from prison back into the prison system. altering their life course and their hope for successful treatment.

This should be a wake-up call to the community that we need quality mental health care and acute care, and the loss of these beds has a significant impact on the community, said consultant Michael Fitzgerald, former executive director of the ‘El Caminos Behavioral Health Hospital of Mountain View.

HCA Healthcare, which operates Mission Oaks at Good Samaritan Hospital, cited staff shortages as the main reason for closing the facility and its pediatric intensive care unit. In a statement, the Nashville-based for-profit company said it had delivered extraordinary efforts during the COVID-19 pandemic to maintain its existing services despite severe staffing challenges.

Unfortunately, in the post-pandemic healthcare ecosystem, we are unable to find qualified personnel for this unit. Staff shortages are not unique to the Good Samaritan and are a national problem, HCA said.

The closure of the Los Gatos facilities comes amid a national mental health crisis. Mental health cases have surged since the pandemic, and Santa Clara County officials have declared a mental health crisis in 2022.

Globally, the prevalence of anxiety and depression increased by 25% in the first year of the COVID-19 pandemic, the World Health Organization reported. Four out of 10 adults in the United States have faced high levels of psychological distress since the start of the pandemic, the Pew Research Center found.

Alexis Crase is a former patient of the Mission Oaks inpatient psychiatric care facility. (Courtesy of Alexis Crase)

COVID has closed many (hospital facilities) and COVID has increased the number of people with mental health issues. So the number of people who need help is growing and the number of resources has been shrinking, Crase said.

Additionally, nearly a quarter of the county’s prison population has a diagnosed mental illness, about 687 out of 2,988 inmates as of January 2022. Of those inmates, 107 are currently awaiting release from prison in a psychiatric treatment facility, but there are none. they’re read enough for them, said Santa Clara County Superior Court Judge Stephen Manley, who has been a longtime advocate for mental health treatment while in prison.

These patients must meet a high standard for admission, Manley said, including a thorough medical and psychological evaluation, but often still face months in jail before receiving treatment.

Every bed we lose makes it harder for people to try to get help, Manley said. I see it every day just a dramatic increase in the number of people needing care at the highest level. This is the highest I’ve seen in many, many years.

The longer treatment is delayed, the worse the condition of the detainees becomes, Manley said. Some end up being released without treatment only to end up back in court.

Emergency rooms are also at risk of overcrowding and turning into hospital care waiting rooms, where some patients already spend days waiting for a bed to open, Fitzgerald said.

If someone attempts or has suicidal thoughts and is admitted to the emergency room, doctors will determine if they need to be admitted to an inpatient facility, which is among the most intensive forms of mental health care and offers patients therapy sessions, plans treatment and 24-hour monitoring. With fewer beds available, these patients have nowhere to go, which could leave even more people waiting in emergency departments or put patients at risk of being sent home rather than to a center where they could get the help they need.

Crase said she was once released from the emergency room after seeking help with suicidal thoughts because there were no beds available in the Bay Area or even as far away as Sacramento.

They sent me home as a suicide when I wanted help, she said.

Tracey Wetherell, a former Mission Oaks nurse, said the lower nurse-to-patient ratio at the facility has led to more personalized care and higher quality treatment. It is guaranteed when you have a 1:6 ratio that at least once a day someone will sit down with this person if she is able.

What set Mission Oaks above other facilities was its nurse-to-patient relationship, Crase said.

That was the only place I trusted. Most of their nurses are so nice they don’t ignore you, she said. If they see that you are angry about something, they talk to you, they try to get to know you. Listen. They’ll sit and talk to you and try to see what’s going on.

The loss of that quality care when a place like Mission Oaks closes is beyond statistics, said retired state Senator Jim Beall, an author of several mental health reform bills. As more and more acute care patients flood into outpatient treatment centers that are ill equipped for their needs, there will be a ripple effect throughout the system.

That’s not just the number of beds and the number of patients, Beall said. It won’t just be 18 people, it will be hundreds of people pushed to different levels of care.

If you or someone you know is struggling with feelings of depression or suicidal thoughts, the National Suicide Prevention Lifeline offers free 24-hour support, information and help resources. Reach out to the lifeline at 800-273-8255 or visit the website SuicidePreventionLifeline.org.

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